012. Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation

Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months. The EHR reporting method also requires and optic disc exam for structural abnormalities.

This measure is to be reported a minimum of once per performance period for patients seen during the performance period. It is anticipated that eligible clinicians who provide the primary management of patients with primary open-angle glaucoma (in either one or both eyes) will submit this measure.

The 2027F Category II code has been retired. Quality Measure 12 (POAG: Optic Nerve Evaluation) is no longer available for claims-based reporting.

Document the optic nerve evaluation:

  1. Document a dilated eye exam.
  2. Document your findings on the Discs and Fundus tabs.
  3. Select a POAG Diagnosis.
  4. Select an optic nerve evaluation Plan. and tap Save.
  5. Document the findings.
  6. Tap Done.
  7. Document the rest of the visit and Finalize.

Alternatively, code quality with a special plan:

  1. Document a Diagnosis and Plan as you normally would.
  2. Tap Special Plans and select MIPS.
  3. From Popular Plans, select MIPS Quality and tap Save.
  4. Locate the MIPS Quality plan and tap Resume.
  5. Tap the POAG tab.
  6. Select an optic nerve evaluation outcome from the Quality 12 drop-down.
  7. Tap Done.
  8. Document the rest of the visit and Finalize.

Eyefinity products and documentation refer to the MIPS quality numbers. Other measure numbering systems are listed here for your reference.

Quality 12
NQF 0086e
CMS 143
  • EHR
  • AAO IRIS
  • MVP

This topic describes how points are calculated for this measure. To learn more about scoring, go to Scoring.

Benchmarks are displayed here as both a chart and a table. The chart gives you a visual representation and helps you quickly compare benchmarks across different reporting methods. The table lists the specific benchmark criteria for each available reporting method.

This measure is capped at a maximum of 7 points based on performance.

 

Submission Method 3rd Decile 4th Decile 5th Decile 6th Decile 7th Decile 8th Decile 9th Decile 10th Decile
AAO IRIS 51.72– 73.40 73.41– 83.97 83.98– 91.29 91.30– 94.92 94.93– 97.22 97.23– 99.08 99.09– 99.99 100
MVP 51.72– 73.40 73.41– 83.97 83.98– 91.29 91.30– 94.92 94.93– 97.22 97.23– 99.08 99.09– 99.99 100

Patients aged 18 years or older;

AND who had a diagnosis of primary open-angle glaucoma:

H40.10X0, H40.10X1, H40.10X2, H40.10X3, H40.10X4, H40.1110, H40.1111, H40.1112, H40.1113, H40.1114, H40.1120, H40.1121, H40.1122, H40.1123, H40.1124, H40.1130, H40.1131, H40.1132, H40.1133, H40.1134, H40.1210, H40.1211, H40.1212, H40.1213, H40.1214, H40.1220, H40.1221, H40.1222, H40.1223, H40.1224, H40.1230, H40.1231, H40.1232, H40.1233, H40.1234, H40.151, H40.152, H40.153

AND who had a visit during the measurement period:

92002, 92004, 92012, 92014, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99304, 99305, 99306, 99307, 99308, 99309, 99310

Denominator Exclusions

Telehealth modifier:

GQ, GT, 95, POS 02, FQ, 93

Denominator Exceptions

Documentation of medical reason(s) for not performing an optic nerve head evaluation:

2027F with 1P modifier

OR [for EHR reporting] documentation of medical reason(s) for not performing a cup-to-disc ratio evaluation or optic disc exam for structural abnormalities:

183932001, 183964008, 183966005, 216952002, 266721009, 269191009, 274512008, 31438003, 35688006, 371133007, 397745006, 407563006, 410534003, 410536001, 416098002, 416406003, 428119001, 445528004, 59037007, 62014003, 79899007

Patients who are included in the denominator;

AND who have an optic nerve head evaluation during one or more office visits within 12 months

Performance Met

Cup-to-disc ratio evaluation performed:

71484-0, 71485-7

AND [for EHR reporting] optic disc exam for structural abnormalities performed:

71486-5, 71487-3